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Single Incision Robotic Colorectal Surgery: History, Indications and Techniques for Success With Single Incision Colectomy
Colorectal Surgery has made significant strides in the last decade progressing from laparoscopy to robotics and from multiple to single port implementations. In select demographics, single incision robotic colectomy (SIRC) can be an effective tool in providing an oncologic resection with excellent cosmesis. We reviewed the current state of single incision robotic colorectal surgery incorporating our institutions retrospective database for single incision robotic surgery from 2010 to 2014 to assess the viability of SIRC. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - April 18, 2016 Category: Gastroenterology Authors: Matthew Skancke, Vincent Obias Source Type: research

Databases: Examining Strengths and weakness of currently available data
Health care delivery necessarily results in an enormous amount of data, and the accumulation of these data into databases presents an important resource for researchers and investigators. An approach to analyzing these databases must account for the sources and shortcomings that are inherent in the generation of these data. In this essay, the opportunities and pitfalls associated with database research are reviewed. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - February 1, 2016 Category: Gastroenterology Authors: David A. Etzioni Source Type: research

Using Nsqip Data for Quality Improvement: The Cleveland Clinic SSI Experience
Prevention of surgical site infection (SSI) has become one of the primary objectives of national quality improvement programs in US hospitals. This chapter will discuss the impact of participation in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) on the outcomes and our experience for SSI reduction. Since 2005, our institution has been an active participant of the ACS-NSQIP, and our SSI rates have been compared with other NSQIP centers; in 2006, we were found to be a high outlier institution for SSI. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - February 1, 2016 Category: Gastroenterology Authors: Cigdem Benlice, Emre Gorgun Source Type: research

Using NSQIP as a Research Tool: How to Answer Questions that are not Amenable to Local Data
The American College of Surgeons’ National Surgical Quality Improvement Program (ACS-NSQIP) releases its de-identified dataset to researchers from participating hospitals annually. This data, with the potential for large sample size, has been frequently utilized to address clinical questions relating to short-term outcomes after surgical procedures, and is highly utilized in colon and rectal surgery publications. Due to its large sample sized and methods of data collection, it is often used to answer clinical questions, which can not be addressed well using single institution databases. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - February 1, 2016 Category: Gastroenterology Authors: Mary R. Kwaan Source Type: research

The American College of Surgeons National Cancer Database: A Successful Initiative in Improving Colorectal Cancer Outcomes
The National Cancer Data Base (NCDB) was created by the American College of Surgeons and the American Cancer Society, in an effort to improve cancer care, by collecting data about patients treated for oncologic disease on a national level. In capturing more than 70% of patients treated for malignancy in the United States, it has allowed researchers to understand the natural history of colorectal cancer (CRC), and analyze the progression and efficacy of therapeutic strategies aimed at CRC. Due to its focus on oncologic disease alone, the NCDB has also allowed subset analysis of specific tumors and patient populations as wel...
Source: Seminars in Colon and Rectal Surgery - February 1, 2016 Category: Gastroenterology Authors: Emily F. Midura, Daniel E. Abbott Source Type: research

The University Healthsystem Constortium Clinical Database: An Emerging Resource in Colorectal Surgery Research
In the era of big data, many options exist for analysis of healthcare related outcomes. The University HealthSystem Consortium Clinical Database/Resource Manager (UHC CDB/RM) represents one such source. With over 400 hospitals participating, UHC comprises >95% of academic centers and their affiliates. Primarily used as an avenue for hospitals to meet requirements in quality assurance activities, it also makes available patient-level data on over 30 million inpatient encounters. In recent years, UHC has been increasingly used to assess quality and cost outcomes for surgical patients, many of which have been specific to colo...
Source: Seminars in Colon and Rectal Surgery - February 1, 2016 Category: Gastroenterology Authors: Rachelle Damle, Karim Alavi Source Type: research

Importance of Partnering with Health Insurance Carriers for Quality Improvement Research
Quality improvement initiatives are integral to the practice of surgery. Collaborative quality improvement (CQI) initiatives engaging providers and payers with a common goal of improving patient care are a powerful tool, which can facilitate data collection, implementation, and subsequent assessment of outcomes. Private payer programs engaging physician driven initiatives have shown statistically significant improvements in patient care. Additionally, established by federal funding, public collaborative quality improvement organizations also serve to intimately pair the hospital, physician and payer in and effort to advanc...
Source: Seminars in Colon and Rectal Surgery - February 1, 2016 Category: Gastroenterology Authors: Yewande Alimi, Elizabeth Wick Source Type: research

Leveraging the Electronic Health Record for Research and Quality Improvement: Current Strengths and Future Challenges
Passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009 resulted in the rapid adoption of Electronic Health Record (EHR) systems. With this, came the promise of increased access to patient data for beneficial secondary uses such as research and quality improvement. However, clinicians and researchers interested in leveraging HIT for such purposes often find EHR data heterogeneous and complex. As such, EHR clinical data often remain underutilized. Biomedical and Health Informaticians are developing systems and techniques to use the EHR for clinical knowledge discovery and dissemina...
Source: Seminars in Colon and Rectal Surgery - February 1, 2016 Category: Gastroenterology Authors: Elliot G. Arsoniadis, Genevieve B. Melton Source Type: research

Statewide Quality Improvement Initiatives in Colorectal Surgery
In this era of evidence-based and cost-efficient medicine, quality assessment and quality improvement programs have become commonplace. On the national level, initiatives such as SCIP and ACS-NSQIP have led to dramatic changes across the United States, providing useful data to evaluate individual hospital's outcomes in attempt to decrease morbidity and mortality. At the regional and state-level, collaborative efforts such as Washington State's SCOAP and the Michigan Surgical Quality Collaborative (MSQC) have led the way to identify focus areas and lead to changes even at the individual surgeon level. (Source: Seminars in C...
Source: Seminars in Colon and Rectal Surgery - February 1, 2016 Category: Gastroenterology Authors: Andrew Schlussel, Scott R. Steele Source Type: research

The University Healthsystem Consortium clinical database: An emerging resource in colorectal surgery research
In the era of big data, many options exist for analysis of health care related outcomes. The University HealthSystem Consortium Clinical Database/Resource Manager (UHC CDB/RM) represents one such source. With over 400 hospitals participating, UHC comprises >95% of academic centers and their affiliates. Primarily used as an avenue for hospitals to meet requirements in quality assurance activities, it also makes available patient-level data on over 30 million inpatient encounters. In recent years, UHC has been increasingly used to assess quality and cost outcomes for surgical patients, many of which have been specific to col...
Source: Seminars in Colon and Rectal Surgery - January 31, 2016 Category: Gastroenterology Authors: Rachelle Damle, Karim Alavi Source Type: research

Big Data and Colorectal Surgery
In the present day, surgeons are often inundated with data including, RVU’s, charge and billing data, slot fill rates in clinic, and meaningful use data from the electronic medical record. Though the influx of data can be overwhelming, there are several types of data that can prove useful to us if used correctly. Particularly in the realm of research, there has been a recent explosion of manuscripts in the field of “outcomes” research, utilizing databases. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - January 30, 2016 Category: Gastroenterology Authors: Ian M. Paquette Source Type: research

Public reporting of Outcomes: Implications of Hospital and Physician Comparison Sites
Several events have cascaded into the current climate of quality initiatives to improve the quality and safety of medical care. This has resulted in an explosion of public reporting of hospital and physician outcomes. While the intent is to provide useful and accurate information, there are several limitations to making direct comparisons across hospitals and physicians that care for a variety of patients in varying systemic environments. It is important to understand the limitations of public reporting before the widespread adoption of their use for reimbursement and referral patterns. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - January 30, 2016 Category: Gastroenterology Authors: Amy L Lightner Source Type: research

Introduction
In the present day, surgeons are often inundated with data including, RVUs, charge and billing data, slot fill rates in clinic, and meaningful use data from the electronic medical record. Though the influx of data can be overwhelming, there are several types of data that can prove useful to us if used correctly. Particularly in the realm of research, there has been a recent explosion of articles in the field of “outcomes” research, utilizing databases. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - January 29, 2016 Category: Gastroenterology Authors: Ian M. Paquette Source Type: research

Management of Stress Urinary Incontinence
Female stress urinary incontinence is a common condition with significant impact on a woman’s quality of life. It is often underreported and undertreated, due to differences in definitions and study populations but also due to embarrassment.1 The prevalence of stress urinary incontinence (SUI) ranges from 29-75% with a mean of about 50%.2 (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - January 12, 2016 Category: Gastroenterology Authors: Manuel DiBiase, Neha Malhorta, Ervin Kocjancic Source Type: research

Management of pelvic pain
Pelvic pain is a common complaint of women that is frequently poorly managed. Diagnosis of pelvic pain in women can be challenging because many symptoms and signs are insensitive and nonspecific. The complex innervation of the pelvis and the anatomical proximity of pelvic viscera mean this symptom frequently overlaps traditional medical specialties, leading to diagnostic delay and frequently inadequate treatment. As the first priority, urgent life-threatening conditions (e.g., ectopic pregnancy, appendicitis, ruptured ovarian cyst) and fertility-threatening conditions (e.g., pelvic inflammatory disease, ovarian torsion) mu...
Source: Seminars in Colon and Rectal Surgery - January 11, 2016 Category: Gastroenterology Authors: Pouya Javadian, S. Abbas Shobeiri Source Type: research